The reliability of the twelve-item general health questionnaire (GHQ-12) under realistic assumptions.
The reliability of the twelve-item general health questionnaire (GHQ-12) under realistic assumptions.
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DOI：
10.1186/1471-2458-8-355
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发表时间：
2008-10-14
影响因子：
4.5
通讯作者：
Hankins M
中科院分区：
文献类型：
--
作者：
Hankins M
制定了12项一般健康问卷（GHQ-12），以筛查非特异性精神疾病。它已被广泛验证并被认为是可靠的。这些验证研究假设GHQ-12是一维的，没有反应偏差，但最近的证据表明，这些假设可能都不正确，威胁到它作为筛选工具的效用。由于GHQ-12评分方法的多样性，进一步产生了不确定性。本研究拟建立三种评分方法（Likert， GHQ和C-GHQ）对GHQ-12的最佳拟合模型，并计算这些更现实假设下的测量误差程度。GHQ-12数据来自2004年英格兰健康调查队列（n = 3705）。采用结构方程模型对一维模型、当前“最佳拟合”三维模型和具有响应偏差的一维模型进行拟合评估。对每个模型评估了三种不同的评分方法。对最佳拟合模型进行了信度、计量标准误差和判别性评估。结果表明，最优拟合模型为一维拟合模型，且负性条目存在反应偏倚，表明以往的GHQ-12因子结构是分析方法的人为产物。所有评分方法的Cronbach's Alpha均高估了该模型的信度：0.90 （Likert法）、0.90 （GHQ法）和0.75 （C-GHQ法）。更现实的可靠性估计分别为0.73、0.87和0.53 （C-GHQ）。不同评分方法的辨别力（Delta）也不同：Likert法为0.94，GHQ法为0.63，C-GHQ法为0.97。由于GHQ-12在负面项目上的反应偏差，使用因子分析和信度估计的传统心理测量评估掩盖了GHQ-12的实质性测量误差，这限制了它作为精神疾病筛查工具的效用。
The twelve-item General Health Questionnaire (GHQ-12) was developed to screen for non-specific psychiatric morbidity. It has been widely validated and found to be reliable. These validation studies have assumed that the GHQ-12 is one-dimensional and free of response bias, but recent evidence suggests that neither of these assumptions may be correct, threatening its utility as a screening instrument. Further uncertainty arises because of the multiplicity of scoring methods of the GHQ-12. This study set out to establish the best fitting model for the GHQ-12 for three scoring methods (Likert, GHQ and C-GHQ) and to calculate the degree of measurement error under these more realistic assumptions. GHQ-12 data were obtained from the Health Survey for England 2004 cohort (n = 3705). Structural equation modelling was used to assess the fit of the one-dimensional model the current 'best fit' three-dimensional model and a one-dimensional model with response bias. Three different scoring methods were assessed for each model. The best fitting model was assessed for reliability, standard error of measurement and discrimination. The best fitting model was one-dimensional with response bias on the negatively phrased items, suggesting that previous GHQ-12 factor structures were artifacts of the analysis method. The reliability of this model was over-estimated by Cronbach's Alpha for all scoring methods: 0.90 (Likert method), 0.90 (GHQ method) and 0.75 (C-GHQ). More realistic estimates of reliability were 0.73, 0.87 and 0.53 (C-GHQ), respectively. Discrimination (Delta) also varied according to scoring method: 0.94 (Likert method), 0.63 (GHQ method) and 0.97 (C-GHQ method). Conventional psychometric assessments using factor analysis and reliability estimates have obscured substantial measurement error in the GHQ-12 due to response bias on the negative items, which limits its utility as a screening instrument for psychiatric morbidity.
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DOI：
10.1348/000711001159582
发表时间：
2001-11-01
影响因子：
2.6
作者：
Raykov, T
通讯作者：
Raykov, T
DOI：
10.1186/1745-0179-4-10
发表时间：
2008-04-24
期刊：
Clinical practice and epidemiology in mental health : CP & EMH
影响因子：
--
作者：
Hankins, Matthew
通讯作者：
Hankins, Matthew
影响因子：
1.2
作者：
Raykov, T
通讯作者：
Raykov, T
影响因子：
10.5
作者：
GOODCHILD, ME;DUNCANJONES, P
通讯作者：
DUNCANJONES, P
影响因子：
4.3
作者：
Greenberger, E;Chen, CS;Farruggia, SP
通讯作者：
Farruggia, SP